PTSD, Post Traumatic Stress Disorder, is defined precisely as it sounds, stress derived after witnessing a traumatic event.
But what is that exactly?
The Diagnostic and Statistical Manual of Mental Disorders (DSM), per the American Psychiatric Association states the critera to be diagnosed with PTSD is:
Criterion A (one required)
The person was exposed to: death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, in the following way(s):
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Direct exposure
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Witnessing the trauma
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Learning that a relative or close friend was exposed to a trauma
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Indirect exposure to aversive details of the trauma, usually in the course of professional duties (e.g., first responders, medics)
Criterion B (one required)
The traumatic event is persistently re-experienced, in the following way(s):
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Unwanted upsetting memories
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Nightmares
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Flashbacks
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Emotional distress after exposure to traumatic reminders
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Physical reactivity after exposure to traumatic reminders
Criterion C (one required)
Avoidance of trauma-related stimuli after the trauma, in the following way(s):
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Trauma-related thoughts or feelings
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Trauma-related reminders
Criterion D (two required)
Negative thoughts or feelings that began or worsened after the trauma, in the following way(s):
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Inability to recall key features of the trauma
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Overly negative thoughts and assumptions about oneself or the world
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Exaggerated blame of self or others for causing the trauma
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Negative affect
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Decreased interest in activities
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Feeling isolated
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Difficulty experiencing positive affect
Criterion E (two required)
Trauma-related arousal and reactivity that began or worsened after the trauma, in the following way(s):
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Irritability or aggression
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Risky or destructive behavior
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Hypervigilance
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Heightened startle reaction
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Difficulty concentrating
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Difficulty sleeping
Criterion F (required)
Symptoms last for more than 1 month.
Criterion G (required)
Symptoms create distress or functional impairment (e.g., social, occupational).
Criterion H (required)
Symptoms are not due to medication, substance use, or other illness.
Two specifications:
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Dissociative Specification. In addition to meeting criteria for diagnosis, an individual experiences high levels of either of the following in reaction to trauma-related stimuli:
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Depersonalization. Experience of being an outside observer of or detached from oneself (e.g., feeling as if "this is not happening to me" or one were in a dream).
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Derealization. Experience of unreality, distance, or distortion (e.g., "things are not real").
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Delayed Specification. Full diagnostic criteria are not met until at least six months after the trauma(s), although onset of symptoms may occur immediately.